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Esophageal pulse oximetry utilizing reflectance photoplethysmography
Panayiotis A Kyriacou1, Sarah Powell, Richard M Langford
1Medical Electronics and Physics, Department of Engineering, Queen Mary, University of London, London E1 4NS, UK. P.A.KYRIACOU@qmul.ac.uk
IEEE Transactions on Bio-Medical Engineering
|November 27, 2002
Summary
Esophageal pulse oximetry offers a reliable alternative for monitoring blood oxygen saturation (SpO2) when finger-based devices fail during major surgery. This innovative approach ensures continuous SpO2 monitoring in patients with poor peripheral perfusion.
Area of Science:
- Medical Devices
- Cardiothoracic Surgery
- Physiological Monitoring
Background:
- Peripheral perfusion is often compromised during prolonged major surgery, leading to unreliable arterial blood oxygen saturation (SpO2) readings from standard finger pulse oximeters.
- Central circulation may maintain better perfusion, making alternative monitoring sites crucial in critical care settings.
Purpose of the Study:
- To develop and evaluate an esophageal pulse oximeter as a reliable alternative for monitoring SpO2 in cardiothoracic surgery patients.
- To assess the accuracy and reliability of esophageal SpO2 measurements compared to traditional arterial blood gas analysis.
Main Methods:
- Development of a reflectance esophageal pulse oximeter probe and a LabVIEW-based processing system.
- Clinical evaluation involving 49 cardiothoracic surgery patients.
- Comparison of esophageal SpO2 readings with arterial oxygen saturation (SaO2) from blood gas analysis and CO-oximetry.
Main Results:
- Esophageal SpO2 values showed good agreement with SaO2 from blood gas analysis (mean difference: 0.02 +/- 0.88%) and CO-oximetry (mean difference: -0.73 +/- 0.72%).
- The esophageal pulse oximeter provided reliable readings in 10.2% of patients where finger oximetry failed for over 10 minutes.
- Demonstrated the feasibility of continuous monitoring even with compromised peripheral perfusion.
Conclusions:
- The esophagus serves as a viable alternative site for pulse oximetry monitoring during major cardiothoracic surgery.
- Esophageal pulse oximetry can maintain reliable SpO2 measurements when peripheral monitoring fails.
- This technology enhances patient safety by ensuring continuous oxygen saturation monitoring in challenging surgical conditions.